改良后外侧入路支撑钢板治疗后侧Pilon骨折的临床研究

Improved posterolateral approach plate for the treatment of posterior Pilon fracture

目的探讨改良后外侧入路支撑钢板治疗后侧Pilon骨折患者踝关节功能及疼痛的影响。方法选择2013年1月～2017年6月在本院就诊的后侧Pilon骨折患者30例进行研究。采用随机数字表法将患者分为两组,每组各15例。照组采用传统后外侧入路手术支撑钢板固定;观察组采用改良的后外侧入路手术支撑钢板固定。两组患者术后随访6～18个月,对比两组患者踝关节功能及疼痛情况。结果在手术时间、住院时间方面,两组患者基本相当,比较差异无统计学意义;在骨折愈合时间方面,观察组明显短于对照组,比较差异有统计学意义(P<0.05)。观察组踝关节功能优良率为86.67%,明显高于对照组的46.67%(P<0.05)。治疗前两组疼痛情况相当,治疗后两组疼痛均明显改善(P<0.05),但观察组改善程度更明显(P<0.05)。结论改良后外侧入路支撑钢板与传统后侧入路手术支撑钢板固定相比治疗后侧Pilon骨折可明显缩短骨折愈合时间、改善患者踝关节功能、缓解疼痛。

Objective To investigate the effect of modified posterolateral approach plate for treatment of ankle joint function and pain in patients with Pilon fractures. Methods Thirty patients with Pilon fractures who were treated in our hospital from January 2013 to June 2017 were selected for study. Patients were divided into two groups using a random number table method, 15 in each group. The control group was fixed with a traditional posterolateral approach surgical support plate; the observation group was fixed with a modified posterolateral approach surgical support plate. The patients in both groups were followed up for 6 to18 months. The ankle joint function and pain were compared between the two groups. Results In terms of operation time and length of stay, the two groups of patients were basically the same, with no significant difference. In the fracture healing time, the observation group was significantly shorter than the control group, and the difference was statistically significant （P〈0.05）. The excellent and good rate of ankle joint function in the observation group was 86.67%, which was significantly higher than that in the control group （46.67%） （P〈0.05）.Before the treatment, the pain in the two groups was similar. After the treatment, the pain in both groups was significantly improved （P〈0.05）, but the improvement was more obvious in the observation group （p〈 0.05）. Conclusion Improved treatment of posterior Pilon fractures in the posterolateral approach plate compared with the traditional posterior approach plate can significantly shorten fracture healing time, improve ankle function, and relieve pain.